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function checkForm(theform) { 

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<form action="c_promoter.php" method="post" name="theform" onSubmit="return checkForm(theform);">
  <!--hidden filed-->
  <input class="text" name="action" type="hidden" value="add">
  <br>
  <table width="95%" border="0" align="center">
    <tr>
      <td align="right"><input type="image" src="../images/admin/bt_cancel.gif" width="78" height="23" onclick="Redirect('c_promoter.php',1);return false;">
        <input type="image" src="../images/admin/bt_save.gif" width="76" height="22">
      </td>
    </tr>
  </table>
  <table width="95%" border="0" align="center">
  <tr>
    <td valign="top">&nbsp;</td>
  </tr>
  <tr>
    <td valign="top"><table width="100%"  border="0" cellspacing="10" cellpadding="0">
        <tr>
          <td align="left" valign="top"><table width="100%"  border="0" cellspacing="0" cellpadding="0">
              <tr>
                <td align="left" valign="top" ><table width="100%"  border="0" cellspacing="2" cellpadding="0">
                  </table>
                  <table width="90%"  border="0" cellspacing="2" cellpadding="0">
                    <tr>
                      <td >Password* :</td>
                      <td><input class="text" name="password"  type="password" id="password" style="width:195px" /></td>
                    </tr>
					
                    <tr>
                      <td >Verify* :</td>
                      <td><input class="text" name="verify"  type="password" id="verify" style="width:195px" /></td>
                    </tr>					
                    <tr>
                      <td >Status:</td>
                      <td><select name="status" id="status">
                          <option value="0" >Non-Approve</option>
                          <option value="1">Approved</option>
                          <option value="2" >Disapproved</option>
                        </select>               </td>
                    </tr>
                    <tr>
                      <td width="165" >Company :</td>
                      <td><input class="text" name="company" type="text" id="company" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >First Name* :</td>
                      <td><input class="text" name="firstname" type="text" id="firstname" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >Last Name* :</td>
                      <td><input class="text" name="lastname" type="text" id="lastname" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >Website:</td>
                      <td><input class="text" name="website" type="text" id="website" style="width:350px"></td>
                    </tr>
                    <tr>
                      <td >Street :</td>
                      <td><input class="text" name="street" type="text" id="street" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >City :</td>
                      <td><input class="text" name="city" type="text" id="city" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >State / Province :</td>
                      <td><input class="text" name="state" type="text" id="state" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >ZIP / Postal Code :</td>
                      <td><input class="text" name="zip" type="text" id="zip" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >Country / Region :</td>
                      <td><input class="text" name="country" type="text" id="country" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >&nbsp;</td>
                      <td>&nbsp;</td>
                    </tr>
                    <tr>
                      <td ><strong>Delivery (if other than above):</strong></td>
                      <td>&nbsp;</td>
                    </tr>
                    <tr>
                      <td >Street :</td>
                      <td><input class="text" name="street2" type="text" id="street2" style="width:195px"  /></td>
                    </tr>
                    <tr>
                      <td >City :</td>
                      <td><input class="text" name="city2" type="text" id="city2" style="width:195px"  /></td>
                    </tr>
                    <tr>
                      <td >State / Province :</td>
                      <td><input class="text" name="state2" type="text" id="state2" style="width:195px"  /></td>
                    </tr>
                    <tr>
                      <td >ZIP / Postal Code :</td>
                      <td><input class="text" name="zip2" type="text" id="zip2" style="width:195px"  /></td>
                    </tr>
                    <tr>
                      <td >Country / Region :</td>
                      <td><input class="text" name="country2" type="text" id="country2" style="width:195px" /></td>
                    </tr>
                    
                    <tr>
                      <td >&nbsp;</td>
                      <td>&nbsp;</td>
                    </tr>
                    <tr>
                      <td >Phone* :</td>
                      <td><input class="text" name="phone1" type="text" id="phone1" style="width:40px">
                        <input class="text" name="phone" type="text" id="phone" style="width:149px"></td>
                    </tr>
                    <tr>
                      <td >Mobile :</td>
                      <td><input class="text" name="mobile1" type="text" id="mobile1" style="width:40px">
                        <input class="text" name="mobile" type="text" id="mobile" style="width:149px"></td>
                    </tr>
                    <tr>
                      <td >Fax:</td>
                      <td><input class="text" name="fax1" type="text" id="fax1" style="width:40px"  />
                          <input class="text" name="fax" type="text" id="fax" style="width:149px" /></td>
                    </tr>
                    <tr>
                      <td >Email* :</td>
                      <td><input class="text" name="email" type="text" id="email" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >&nbsp;</td>
                      <td>&nbsp;</td>
                    </tr>
                    <tr>
                      <td height="30" class="title03">Banking Information:</td>
                      <td >&nbsp;</td>
                    </tr>
                    <tr>
                      <td >Bank :</td>
                      <td ><input class="text" name="b_bank" type="text" id="b_bank" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >Registration no. :</td>
                      <td ><input class="text" name="b_registration" type="text" id="b_registration" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >Account no. :</td>
                      <td ><input class="text" name="b_account" type="text" id="b_account" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >IBAN code :</td>
                      <td ><input class="text" name="b_iban" type="text" id="b_iban" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >SWIFT code :</td>
                      <td ><input class="text" name="b_swift" type="text" id="b_swift" style="width:195px"></td>
                    </tr>
                    <tr>
                      <td >Rank :</td>
                      <td ><input name="rank" type="radio" value="1"  checked="checked" />
                        Silver
                        <input name="rank" type="radio" value="2"  />
                        Gold
                        <input name="rank" type="radio" value="3" />
                        Platinum </td>
                    </tr>
                    <tr>
                      <td>&nbsp;</td>
                      <td>&nbsp;</td>
                    </tr>
                  </table>
                  <table width="100%"  border="0" cellspacing="2" cellpadding="0">
                    <tr>
                      <td height="30" class="title03">Promoter Commission:</td>
                      <td>&nbsp;</td>
                    </tr>
                    <tr>
                      <td width="95%" align="left" valign="top" >I 
                        would like training/products for commission<br>
                        <span class="littlefont02">When you choose 
                        to receive products and/or courses/training 
                        with Acuity World for commission, we double 
                        your commission.</span> </td>
                      <td width="5%" align="center" valign="top"><input name="faq1" type="radio" class="inputimage" id="faq1" value="1" checked="checked"></td>
                    </tr>
                    <tr>
                      <td height="8" align="left" valign="top" ></td>
                      <td align="center" valign="top"></td>
                    </tr>
                    <tr>
                      <td align="left" valign="top" >I 
                        would like to have my commission paid in cash. 
                        settlement dates</td>
                      <td align="center" valign="top"><input name="faq1" type="radio" class="inputimage" id="faq2" value="0"></td>
                    </tr>
                    <tr>
                      <td align="left" valign="top" >Yes, 
                        I have read and accepted Acuity World WebShop 
                        General Promoter Agreement</td>
                      <td align="center" valign="top"><input  name="faq3" type="checkbox" class="inputimage" id="faq3" value="1"></td>
                    </tr>
                    <tr>
                      <td align="left" valign="top" >Yes, 
                        I have read and accepted Acuity World WebShop 
                        Terms of Sale and Delivery</td>
                      <td align="center" valign="top"><input  name="faq4" type="checkbox" class="inputimage" id="faq4" value="1"></td>
                    </tr>
                    <tr>
                      <td align="left" valign="top" >Yes, 
                        please add my name to the Acuity World WebShop 
                        Promoter List</td>
                      <td align="center" valign="top"><input  name="faq5" type="checkbox" class="inputimage" id="faq5" value="1"></td>
                    </tr>
                    <tr>
                      <td align="left" valign="top" >Yes, 
                        I would like link to my website on Acuity 
                        World WebShop's site</td>
                      <td align="center" valign="top"><input  name="faq6" type="checkbox" class="inputimage" id="faq6" value="1"></td>
                    </tr>
                    <tr>
                      <td align="left" valign="top" >Yes, 
                        I would like to receive a banner for my website<br>
                        <span class="littlefont02">This will guarantee 
                        that your promoter-ID is automatically registered 
                        for the customers referred by you. </span></td>
                      <td align="center" valign="top"><input  name="faq7" type="checkbox" class="inputimage" id="faq7" value="1"></td>
                    </tr>
                    <tr>
                      <td height="8" align="left" valign="top" ></td>
                      <td align="center" valign="top"></td>
                    </tr>
                    <tr>
                      <td align="left" valign="top" >Yes, 
                        please send me the Acuity World Newsletter</td>
                      <td align="center" valign="top"><input  name="faq8" type="checkbox" class="inputimage" id="faq8" value="1" checked></td>
                    </tr>
                    <tr>
                      <td height="30" >&nbsp;</td>
                      <td>&nbsp;</td>
                    </tr>
                  </table>
              </tr>
            </table>
            </td>
        </tr>
      </table>
  <tr>
    <td height="30" align="right" colspan="2"><input type="image" src="../images/admin/bt_cancel.gif" width="78" height="23" onclick="Redirect('c_ promoter.php',1);return false;">
      <input type="image" src="../images/admin/bt_save.gif" width="76" height="22">
    </td>
	</tr></table>
</form>


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